International Urology and Nephrology

, Volume 43, Issue 1, pp 15–22

Xanthogranulomatous pyelonephritis: critical analysis of 30 patients

Authors

  • Chin-Chi Kuo
    • Department of Internal MedicineNational Taiwan University Hospital
  • Ching-Fang Wu
    • Department of Internal MedicineNational Taiwan University Hospital
  • Chun-Chieh Huang
    • Department of Medical ImagingFar Eastern Memorial Hospital
  • Yuan-Ju Lee
    • Department of UrologyNational Taiwan University Hospital
  • Wei-Chou Lin
    • Department of PathologyNational Taiwan University Hospital
  • Ching-Wei Tsai
    • Department of Internal MedicineNational Taiwan University Hospital
  • Vin-Cent Wu
    • Department of Internal MedicineNational Taiwan University Hospital
  • Yung-Ming Chen
    • Department of Internal MedicineNational Taiwan University Hospital
    • Department of Internal MedicineNational Taiwan University Hospital
  • Tzong-Shinn Chu
    • Department of Internal MedicineNational Taiwan University Hospital
  • Kwan-Dun Wu
    • Department of Internal MedicineNational Taiwan University Hospital
Urology – Original Paper

DOI: 10.1007/s11255-010-9778-8

Cite this article as:
Kuo, C., Wu, C., Huang, C. et al. Int Urol Nephrol (2011) 43: 15. doi:10.1007/s11255-010-9778-8

Abstract

Introduction and objective

Xanthogranulomatous pyelonephritis (XGP) is a chronic inflammatory condition of the kidneys. Nevertheless, disparities between the pre-operative and pathological diagnoses are frequently encountered. We reviewed all patients with XGP over a 17-year period to identify and characterize the pre-operative and pathological characteristics of the disease in our patients.

Methods

A comprehensive review of all nephrectomy patients with a pre-operative diagnosis of pyelonephritis at National Taiwan University Hospital from 1991 to 2008 with the pathological diagnosis of XGP was conducted to demonstrate the clinical and radiological characteristics of XGP.

Results

XGP was diagnosed in 30 (18.6%) of the 160 nephrectomies performed for pyelonephritis. Of the 30 patients with XGP, 25 were women (83.3%) and 20 (66.7%) were overweight (body mass index >23). Their mean age was 55.17 years. The average serum creatinine level was 1.68 mg/dL. The image findings included renal calculi (56.7%), staghorn stones (26.7%), and spread of the disease to the retroperitoneum and psoas muscle (33.3%). Escherichia coli (36.7%) was the most prevalent pathogen. The mortality of the two-stage surgical treatment was zero, and morbidity developed in only 1 patient (4.8%).

Conclusion

The key to accurate pre-operative diagnosis is to keep risk factors in mind such as age, sex, and renal calculi. Clinicians should maintain a high suspicion of XGP for early recognition and be aware of the care of chronic kidney disease. Finally, the association between XGP and central obesity warrants further research.

Keywords

Xanthogranulomatous pyelonephritisBody mass indexVisceral adipose tissueChronic kidney disease

Copyright information

© Springer Science+Business Media, B.V. 2010